Welcome, friend! A few months back, I had chatted with neurosurgeon Gary R Simonds about the profession. Gary bringing many of his experiences from there into his latest release , Death’s Pale Flag. Le’s learn more about the book!

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Get to know the author: Gary R Simonds

Welcome back Gary! Tell my new readers a bit about yourself.

Born to a Scottish mother and American father, I have lived in the US and the UK. I was a practicing neurosurgeon until a few years ago, having performed over 13,000 brain and spinal operations in adults and children, and treated tens of thousands of seriously ill and injured patients. I now teach and advise undergraduates and medical students at Virginia Tech on a host of subjects. I love to read, write about, and give talks on neuroscience, medical ethics, medical humanism, healthcare delivery, burnout, wellness, and the interface between science and religion. I’m kind of a soccer nut (favorite teams – Manchester United and Asheville City SC). I play guitar and banjo and plan on learning the bagpipes this year. I now live in beautiful Black Mountain NC with my wife Cindy, and our border collie, Hamish.

What inspired you to write this book?

Several things. 

I wanted to give the reader an immersive peek behind the curtain of modern high-end medical/neruosurgical care. And please note, there is no hyperbole in the medical/surgical passages – I wrote them as they truly take place. I wanted the reader to better understand what can and cannot be done for a number of dire brain conditions. I wanted the reader to feel the tension, the joy, and the sorrow of trying to care for the very sickest of some very sick patients. I also wanted them to understand that the physicians (and all the healthcare workers, for that matter) are very human, and are vulnerable to constant exposure to human suffering, death, and tragedy. I wanted people to appreciate the bravery, and resilience, and shear of patients and families dealing with devastating diseases and injuries that can only be witnessed behind the scenes in hospital ICU’s, E.R.’s, and operating rooms. 

And, I love a good scare! So, I decided to wrap all of the above in a ghost story/thriller. Is the protagonist surgeon actually seeing ghosts, or is he losing his mind? I also wanted to challenge the reader to consider who can provide the most terror and scares – the supernatural world or the natural world, as witnessed in a modern medical center. 

How long did it take you to write this book, from the first idea to the last edit?

Well, I started it twenty years ago. I would work on it sporadically and had its bones all laid out and many chapters written. Over the past four years I worked on it pretty intensively (along with a YA soccer novel, and a non-fiction book on burnout). It eventually swelled to over 260,000 words. There were witches and affairs and several other characters, and more surgery and scares, but a lot ended up on the “cutting room floor.” I did keep a fair amount of surgical and hospital scenes, though, to give the reader a sense of the relentlessness of horrible injuries and illnesses that come into a big medical center.

What makes your story unique?

I don’t believe there are many neurosurgery novels out there – particularly ones written by actual neurosurgeons who have actually “walked the walk,” if you will. All the medical/surgical scenes in the book are realistic in their depiction of events, conversations, surgeries, and hospital personnel behavior. And the paranormal twist makes it especially unique. 

Who would enjoy reading your book? 

I think and hope anyone who enjoys serious adult fiction themes of struggle, overcoming adversity, compassion, self-reflection and self-doubt, bravery, psychological distress, resilience, kindness, humanity, marital strain, work-life balance (more like imbalance), friendship, community, the interface of science and religion,  and a sprinkle of irony and ironic humor. 

Also, readers interested in coming to fully appreciate the behind-the-scenes world of neurosurgery and major healthcare delivery. And, those who also wish to learn a little neuroscience along the way.

I’m hoping readers who enjoy a psychological thriller will resonate with the plight of the main protagonist, Ryan Brenan, a surgeon sinking under the weight of his commitment to his patients (and an army of ghosts).

And, I hope paranormal enthusiasts will enjoy the thrills and chills of escalating incursions into Ryan’s life. 

Do you have a favourite quote or scene in the book that you find yourself going back to?

I make myself cry with a scene fairly late in the book where the central protagonist, brain surgeon Ryan Brenan speaks with a teenage girl who has recently learned she has an incurable brain tumor. In it, I tried to reflect the braver and amazing grace that I witnessed so often in so many of my patients. I cannot pay tribute enough to these amazing people. 

“Will it be painful? I mean, when I die.”

Ryan swallowed hard. “Who says you’re going to die?”

“Um, I checked the stats.” Mia rolled her eyes. “They don’t leave much doubt.”

“Be careful of all those statistics, Mia. They sound wretched, but they’re just an average of responses. No one says they’ll apply to you. And there are always exceptions to the rule .” Ryan shuddered at the thought of how empty his reassurances sounded.

“You don’t have to be so gentle with me, Dr. Brenan,” replied Mia, eyebrows furrowed a little. “I know the score. Please, just be as straight with me as you can, okay?”

What is something you have learned on your author journey so far?

Writing novels is much harder than writing non-fiction. But, oh my goodness is it fun. You can create any scene, place, situation, universe you want. The options are infinite. This, I suppose, is a joy and a curse!

Lesson two: you so desperately want others to read your story. Not for fame or fortune, but to see if anyone resonates with your thoughts, your feelings, your soul – because you lay it all out there in the writing.

Lesson three: I am super lucky. I love to edit my own work. I love critique from anyone and everyone. And I love rewriting. All things that might turn off a writer. 

What’s the best piece of advice you have received related to writing?

Oh my goodness. So much. From so many people – directly and through books and websites. What helped me was to not try to be perfect on the first draft. Or the first twenty drafts. Throw it all out there on the page. Let your mind spill out. Just write and revise and write and revise and seek commentary and write and revise and write and revise. Oh, and save the stuff you cut out – it may work for other books or other pieces of writing or even some talks. 

If you could give a shout out to someone(s) who has helped in your writer journey, please feel free to mention them below!

So much tolerance and help from my family including Cindy, Sean, Colin, Craig, Katherine, Isla, and Meghan. Much mentorship in the world of emotional distress and burnout from my friend, Wayne Sotile. Support and encouragement from my neurosurgical colleagues and residents. And much, much inspiration from my patients and their families. 

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Book Excerpt from
Death’s Pale Flag

After changing out of his scrubs, Ryan made his way to the 8 North ICU to do a final check on several of his “sickos,” then blitzed through 8 West toward a back staircase that led to the doctor’s parking lot. Halfway down the hallway, he almost ran over a woman in an all-too-familiar cancer turban. It was Delores Sopena. Mrs. Sopena was a beautiful African American woman of thirty-two when she first presented to the medical center with convulsions. She was found to have a fungating left-sided brain tumor which proved to be a gliosarcoma—an evil relative of glioblastoma. With Ryan, she went through surgery, chemotherapy, radiation, and experimental gene therapy. The experimental therapy had been so ineffective in other patients that the residents had christened it “glioma-chow.” To everyone’s delight, though, Mrs. Sopena went five years with no signs of tumor recurrence. Ryan saw her in his clinic monthly. She was such a delightful person and was so full of gratitude for every additional minute of life, that every time she came in, Ryan found himself praying to a God he didn’t necessarily believe existed to please, oh please, deliver her from her disease.

And it seemed to work. Until it didn’t. Until Ryan’s God dropped the ball. Five years and two weeks after her original surgery, after years of “clean” MRIs, she had another seizure. The tumor had made its reappearance and was now double its original size. Ryan reoperated and cleaned out all visible tumor; but then after, three months, it was back and was streaming into the opposite side of Mrs. Sopena’s brain. Her goose was cooked. No further surgery would be of any benefit: radiation had been used up, and any further chemotherapy regimen was likely only to make her miserably sick. After two more months, the tumor was everywhere, and the only thing that kept Mrs. Sopena going was increasing doses of medicinal steroids. Two weeks prior to this evening, she had missed an appointment and Ryan assumed the worse. But here she was in the hospital, looking worn, bloated, hairless; and yet, beautiful, due to an inextinguishable inner radiance. 

“Hey there, Mrs. Sopena! Jeez, I almost tripped over you,” said Ryan.

“Hi there, Dr. Brenan!” responded Mrs. Sopena, her incandescent smile lighting up the ward. “How’s my favorite man on God’s own Earth—other than my husband, that is.”

“I’m fine, but what are you doing in the hospital?” 

“Oh, I’m having seizures. They can’t seem to get them under control. I think I’m on four anticonvulsants now, but they keep coming—every so many hours. And they’ve been nasty ones.”

“Sheesh, I’m so sorry,” said Ryan. “Who’s taking care of you?”

“Um, I think it’s supposed to be Dr. Woodfield from Neurology, but I’ve never laid eyes on the man.”

“Christ,” said Ryan, cringing, recalling the obnoxious visage of his least favorite neurologist.

“What was that, Dr. Brenan?” 

“Nothing,” replied Ryan, shaking his head. “How are you feeling?”

“Oh, Dr. Brenan, I do believe it’s my time,” said Mrs. Sopena with a smile and tilt of the head.

“Don’t say that. You look great. This is just a bump in the road,” said Ryan, reaching out to Mrs. Sopena, not at all convinced by his own words.

“No, Dr. Brenan, I can feel it. My spirit is leaving my body as we speak. And that’s all right, I’m ready to be with Jesus.”

“No, Mrs. Sopena, you’ll be fine,” replied Ryan, gently holding Mrs. Sopena’s withered shoulder. “They just need to get the seizures under control. I’ll take a look at your meds myself. I’m sure we can get things worked out and get you home.”

“It’s all right, my sweet man,” replied Mrs. Sopena, patting Ryan’s hand. “I’ve made my peace with it. Gabriel calls and who am I to argue? But I am so filled with joy that I got to see you this one last time. I worried that I wouldn’t after I missed my appointment. But I was so sick to my stomach that day. I didn’t want you to see me that way, to remember me that way.”

“Ah, come on, Ms. Sopena, we’ll have many more visits together. I’ll make sure of it. I’ll call the office tomorrow and get them all scheduled up—every couple of weeks suit you?”

“You’re such a wonderful man, Dr. Brenan,” said Mrs. Sopena, eyes sparkling. “I really will miss you. But we’ll be reunited one day. I’m certain of it.” She stepped into Ryan and gave him a hug so filled with love and gratitude that it took his breath away. “You go now, Dr. Brenan. You go see your beautiful family.” She broke away and entered her room. 

Ryan, with no family to see, turned and made his way to the nurses’ station, intent on looking up the medications the moron Woodfield had placed her on. Hopefully, he could get them straightened out. He sat down and fired up the electronic medical records program and pulled up her chart.

“What the hell?” The words burst from his lips.

He sat transfixed. At the top of the chart, flanking Mrs. Sopena’s name, in bold, bright-red lettering, was the word: “Deceased.”

“It’s not possible.” He hit the Goggle icon on the home screen and punched in Delores Sopena, Eliasburg, Pennsylvania. And there it was.

“Mrs. Delores Sopena, beloved wife and mother, was united with our Lord and Savior, Jesus Christ, after a five-year battle with brain cancer on Tuesday, the seventh of February. Mrs. Sopena, originally of Asheville, North Carolina is survived by . . .”

Ryan couldn’t read on due to the thick screen of tears in his eyes. He pushed himself away from the keyboard and made his way to Mrs. Sopena’s room. It was empty of all beings—dead or alive. 

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Interested?

Find Death’s Pale Flag on Goodreads and Amazon.

Thank you for hanging out with us today. Connect with Gary on Twitter and Facebook.

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Cover Photo on Unsplash